Methocarbamol- Robax

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ShiftKicker

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Hi there-

I've been experiencing an increase in discomfort due to spasticity recently. I refer to it as discomfort, as it is nothing to what I used to experience with sports injuries and sporting wear and tear in the good old days, but it is constant and tiresome. I have tried to mitigate it with Robax/methocarbamol+ibuprophen, which seems to work for short periods of time.

I am reluctant to start taking more Tizanidine (because I pass out when I take even 2mg) or Baclofen (which increases my spasticity for some reason). Is anyone taking a prescription level of Methocarbamol for discomfort? Or, any other method of pain relief other than the usual Aspirin/Tylenol/Ibuprophen? None of these are up to the job, but I am reluctant to use opiates due to the addiction factor and the thoughts that I may need to use them later down the road.

Thanks in advance for any input-

Fiona
 
I have had success with very small amounts of Oxycodone. 1/4th of a 15 mg. tablet once a day, usually mid-day. I take lots of magnesium, lots of potassium in the form of coconut water, bananas, and acacados, some Valium, tylenol, advil, and tumeric. I don't take the Oxy every day and was actually off it for two weeks so I've not built a tolerance.
 
A skeletal muscle relaxant (Robax or cyclobenzaprine)makes more sense than opiates for spasticity, generally. But they have a short half life and so for optimal effectiveness need to be dosed 3 or 4x a day. As a reminder to all, caution on any long-term mix of ibu and acetaminophen as data are scant.
 
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Methocarbamol is more of a pain blocker than a true muscle strain relaxant unrelated to the treatment of spasticity, entirely different cause-effect. Good question to go over with your Neuro though. :)
 
Thanks all. I will be speaking with my family doctor about it for sure. It's discomfort I'm trying to deal with, not spasticity. Anything that reduces spasticity makes me tired, hence my attempt to approach dealing with the pain instead.

Al, my neuro is unhelpful for day to day stuff. She is for assessing progression and diagnosis only. She does not take much interest at all in the actual care of her patients and refers all questions about prescriptions and symptoms to the family doctor.
 
Golly, I'd consider another Neuro if possible. A family doctor is not a neurologist and prescribing meds for a neurological condition might be somewhat out of his/her arena. I can online my Neuro with any question and get an answer back within 2 to 3 days. Hope you find something that works.
 
Al, this is why this forum is a good resource for information for some of us. Not everyone has access to the best medical care for neurological conditions or a big ALS centre for excellence. We make do with what we have.
 
Ok, that's a fair reply. I was just going by when you wrote,

"She does not take much interest at all in the actual care of her patients and refers all questions about prescriptions and symptoms to the family doctor."

Again, hope you find what works for your condition.
 
I'm very fortunate to have a local neuro who specializes in pain management. He also favors alternative treatment. His opinion is that whatever works to make each day good is what I should be doing. He advises me of the risks and benefits, encourages me to explore what is out there and is willing to write an Rx for anything I think might help. He is the only neuro I've come across who knows a lot about supplements (pro and con.)

Laurie, I do take Tylenol and Advil. Tylenol in the morning and Advil in late afternoon. Only one of each. I take the Tumeric with the Advil. Not really sure on the timing of things but this combo seems to help me stay off the Oxy most days. My gut can't tolerate aspirin. I could take more Tylenol and cut out the Advil but I'm not getting the anti-inflammatory benefit from the tylenol.

My neuro at the ALS Center suggested I add back a small amount of Neurontin at bedtime (100-200 mg.) I had stopped that for awhile.
 
Acetaminophen is not an NSAID In general you can take them on the same day though you should be cautious if doing higher dose or long term. I would not take both round the clock but if you have no complicating issues ( kidney, liver) and your doctor sees no problem I fail to see why you should not take a single dose of each if it works for you Kim
 
Fiona, you're right... you just got some good info here. But... it's still best to run all this by your family doctor (concerning meds) for safe measure. The most common prescriber in this country of Methocarbamol are/is Ortho doctors relating to muscle strain. Somewhat different than what someone with a diagnosis of PLS concerning the messages from the Primary Motor Cortex versus a "pulled muscle" apply.
 
OK, true, acetaminophen is not an NSAID in terms of class. But because there is little data on the long-term effects of taking it w/ NSAIDs long-term, as Nikki points out, many people like me group them together in shorthand for that reason.

NSAIDs have been linked with more long-term sequelae than acetaminophen, so if the pain responds to acetaminophen in normal doses, IMHO that's the way to go. The distinction between acetaminophen and NSAIDs on the basis of this "inflammation" mechanism is a red herring in that case.

The exception includes liver dz and/or regular alcohol consumption, of course.
 
The exception includes liver dz and/or regular alcohol consumption, of course.

Bear in mind that those of us on Riluzole are already stressing our livers.
 
Fiona, it is so unfortunate that you can not be seen be a good caring Neurologist. Your severe reactions (at such low doses) to meds that work so well for so many others with Primary Lateral Sclerosis yet you fear opiates beckons the need for a qualified Neuro. ALS is a very rare and complicated neurological disease and PLS is even rarer. I could research (Google) this, copy, paste to Word, edit, copy, then post here with overly detailed info but the bottom line is... this really needs entire review with your family doctor who hopefully will consult with your Neuro or some qualified Neuro. No one here is a pharmacist or licensed doctor that I know of. But... some of the info you have received here will give you a better conversation with your family doctor. Hoping the best for you and hope you find something that brings some relief for your condition/diagnosis.

Ok, everybody else breath easy... I'm outta here again.
 
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I don't take Riluzole and I don't drink (I know, boring.) My blood pressure has always been low so I'm not concerned with cardiac impact of Advil and I do believe that the anti-inflammatory properties might be a good thing (along with the tumeric and diet.) I was dx with fibromyalgia 15 years ago but was afraid to take Advil, at the time, because my stomach was sensitive. Tylenol is definitely better on the stomach than any other pain med. I have a lot of nerve pain, too, and I'm thinking maybe going back on the low dose neurontin might help more than anything.
 
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